Health Equity: How digitalization can promote global health access

Scissors symbolize a gap and problems in today's society. One of them is global health inequalities: While developed countries tend to have a surplus of doctors and medical professionals, people with medical problems in low-income countries must often travel hundreds of miles before they find access to health services.

At MEDICA 2021, Professor Ralf von Baer gave a talk on health equity. In this MEDICA-tradefair.com interview, he sums up how these disparities in health care can be addressed and what prevents a successful implementation of this type of project at the moment.

Professor von Baer, ​​your presentation discussed digital solutions to confront health equity - what do you mean by that?

Prof. von Baer: We are facing a major imbalance in global health care: you have countries like Indonesia or Nigeria where 1 doctor looks after more than 10,000 residents. What's more, many people in low-income countries primarily die of preventable or treatable diseases such as malaria, HIV, tuberculosis, pregnancy-related complications, or traffic accidents. Again, that's because patients have less or no access to health services since there are not enough doctors to attend to them and the distances to the nearest health facilities are too great. This disparity is growing because we are making our planet sick. Environmental pollution is linked to diseases such as cancer, infections, asthma, or symptoms of poisoning. Global warming leads to serious injuries from an increasing number of natural disasters and results in water poverty and malnutrition. If we do nothing about it, this health gap between rich and poor countries will only widen. Of course, this begs the question of how we can change things. Climate change and environmental degradation are subjects I won't be discussing in this setting – however, digitalization allows us to mitigate the resulting effects and gives us the chance to alleviate the shortage of qualified health care professionals.

People need access to affordable, quality medicine. This is exactly where digitalization comes into play since it facilitates the partial automation of patient care. For example, let's take an app that helps patients to make an initial health assessment. It asks the same questions a doctor would ask when he/she takes down the patient's medical history. The app works as a decision-making tool for the patient, who can determine whether he/she must seek medical attention immediately or whether a visit to the doctor can wait, while he/she starts a simple treatment in the meantime. The physician saves time if he/she receives the health records or consults the patient via a video call.

That being said, not every household needs to have access to digital solutions - it is sufficient if someone you know has the app and you can use their cellphone to enter the data. Or people seek the help of a community worker. This person only has basic medical skills, but digital solutions would enable him/her to make a quick assessment and quickly evaluate the person for signs of illness and possibly start treatment. Another great example of how digitalization plays out on-site is an ultrasound transducer that connects to a smartphone: The community worker performs the ultrasound on the patient, while the doctor then makes a remote diagnosis. In other words, we must automate medical services and take medicine to places it has never been. And while that's not the perfect solution, it is better than the alternative: one doctor per 10,000 residents.

Digitalization doesn't just benefit patients: it also enables medical professionals to do things they could not do in the past. For example, if they must perform an emergency surgery they have never done before, it is preferable for them to connect with a skilled specialist who can talk them through the procedure versus having to look up the process in a textbook. When it comes to caregiving, you could train non-medical caregivers with the help of digital solutions. A caregiver could use augmented reality to learn how to safely turn a patient in bed, for example. Digitalization allows us to empower staff to take on more health-related tasks.

On the face of it, this solution sounds obvious and feasible. But who should pay for it?

von Baer: That is the million-dollar question. If we just look at the numbers, you quickly notice that the developed countries are the biggest carbon polluters that produce the most emissions per capita. The latter contributes to the widening of the gap. For me, it makes sense that those who produce pollution should also bear the costs of managing it and repairing the damages.

All told, this type of project is no longer as costly as it would have been in the past – and it is progressively getting less expensive. Just take a pulse oximeter, for example. The devices used to be very expensive, whereas today they are affordable to where they cost almost as little as a disposable item.

Assuming the cost to address health care disparities are paid for: How long would it take for the gap to at least stop widening?

von Baer: I think it would happen quite quickly since we have all the necessary tools at our disposal and don't need to first come up with a technical innovation. All you need is the right program, which needs to be advertised and promoted. Since the developing countries have poor access to essential health services, they are more likely to accept this proposal over new solutions. Of course, some legal and regulatory requirements must still be considered, but overall, this type of project would be feasible in two to three years. Another advantage is that its implementation would be identical in many countries.

Let's take a final look back at MEDICA 2021: How did you like the trade fair?

von Baer: It was wonderful to meet people face-to-face again. I thought it was amazing that so many international participants came to Düsseldorf. And unlike in previous years, you had fewer people take part, which meant you had more time for longer and more meaningful conversations with colleagues and partners who stopped by for a visit.